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ATI Fundamentals Proctored Practice/79 Questions and Answers
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ATI Fundamentals Proctored Practice/79Questions and Answers
State board of nursing - -laws and regulations that govern nursing in their
state
o Ensure the state hospitals are complying with regulations
o Issue and revoke nursing license
Nurses must have license in every state they practice in
-JCHO - -Regulations for health care facilities
-Medicare - -Eligibility: 65+ , on disability for 2 years, or diagnosed with ALS
and end state renal
failure and on dialysis
o Four parts
A: inpatient, limited skill nursing care, home health
B: outpatient care: diagnostics services, and OT/PT
C: combines A and B and provided through private insurance companies
D: prescription drug coverage
-Medicaid - -Eligible: low socioeconomic status, no insurance, dependent on
size of household
-Ch. 2 Interprofessional Team - -Dietician: assist with NTR needs
- Lab tech: blood draws
- Pharmacy: reviews meds, put in MAR
- PT: mobility
- OT: helps Pt regain ability to perform ADL's
- Provider: can be the doctor or advanced practiced nurses or PA
- Social workers: identifies and coordinates community resources, medical
equipment, and other
needs of the Pt to be discharged from acute care
- Speech/language pathologist: help with speech and swallowing
assessments
o Dysphagia and difficulty swallowing
-Ch. 3 nursing ethical principles - -Autonomy: Pt has a right to make his/her
decision even it is not in their best interest
o Ex. Going AMA
- Beneficence: doing good and best for the patient
o Providing medications, helping the patient, doing the right thing
- Fidelity: keeping your promise
o If you say you're going to find out, then find out
- Justice: providing fairness in care in the allocation of resources
,o You are not giving one Pt more resources than another
- Nonmaleficence: do no harm
o Catching an incorrect prescription dose
- Veracity: telling the truth
o If the Pt asks their diagnosis, tell them their diagnosis
-Torts - -Unintentional tort
o Negligence: Pt is at high risk for falls and you didn't set their bed alarm,
and they fell
o Malpractice: medication error
- Intentional tort
o Assault: threatening
o Battery: following through with a threat
o False imprisonment: inappropriately restrain or administering a sedative
-Informed consent - -necessary for all procedures
o Provider: communicating purpose, giving Pt a complete description of
procedure in the
Pt's primary language, explains R v. B and alternatives to the procedure
o RN: make sure the provider did everything they were supposed to, make
sure the pt was
competent to make the decision (not mentally impaired), have Pt sign
consent
document, and notify provider if Pt has any more questions
o Who can give informed consent?
DPOA: durable power of attorney (Pt gave this person the right to make
decisions)
Emancipated minors
-Refusal of treatment - -Allowed if competent
o AMA: tell provider, tell of risks, and have sign document
-Advanced directives - -Living will: communicates wishes if becomes
incapacitated
- DPOA (durable power of attorney): individual that the Pt designates as their
Proxy
- Providers order for DNR or AND (allow natural death)
- Mandatory reporting
o If you suspect abuse: you must report that
o Communicable reporting mandated by the state
o Impaired coworker
Do not gather more info or talk to her directly—tell the manager
-Information Technology - -Nursing documentation
o Both objective and subjective data
Objective: see, hear, feel, or smell—no interpretation
, Subjective: direct quotes or identify as information provided by the patient
o Never leave blank spaces, never corrections, never scratch or black out,
always include
name and title
o Incident reports: accident of some kind or an unusual event (medication
error or fall)
Do not: refer to incident report in Pt charting, NOT IN THE MEDICAL RECORD
- Telephone order
o Have 2nd RN on call
o Read back prescription order
o Have provider sign this within 24 hours
- HIPPA/information security
o In place to ensure confidentiality of health information
o Only persons responsible for Pt care are allowed to read record
o Communication about Pt must be in private or at the nurses station
o Password protect electronic records, don't share records
o Don't share information with unauthorized people
Such as the people in the room
o Code system can be used: like a number—family can get info if they tell
you the code
-Delegation - -Do not delegate
o Pt information (initial teaching)
o Any task that require nursing judgement or nursing assessment
- Can be delegated to LVN (practical nurse)
o Medication admin
o Enteral feedings
o Suctioning
o Tracheostomy care
o Reinforce patient teaching
- Can be delegated to CAN
o Bathing, dressing, ambulating, toileting, feeding Pt's who do not have
swallowing
difficulties (if Pt has dysphagia, you need to do it), positioning, taking vitals,
collecting
specimens, reporting I/O
- 5 rights of delegation
o Right task: repetitive, relatively non-invasive, and doesn't require
supervision
o Right circumstance: never assign an unstable Pt to an LVN, right person
o Right direction and communication: timeline, expected result, and follow-
up
communication (such as if vitals are abnormal)
o Right supervision and evaluation: may need to intervene or provide
feedback
, -Nursing Process - -Assessment and date collection
o Subjective data (symptoms): pain level, how they're feeling
o Objective data (signs): temp, BP, capillary refill
- Analysis and more data collection
o Cluster collected date, ID patterns and trends, compare data to expected
values
o Forms picture of Pt condition and identifies trends
o primary source: what they Pt tells you and what you see yourself
o Secondary source: what others tell the nurse about the patient
Can come from the medical record
- Planning:
o Prioritize interventions
o Identify measurable outcomes: time limited, not vague
Vague: hopefully they will breathe better tomorrow
Not vague: Pt will not complain of dyspnea tomorrow
- Implementation:
o Perform actual nursing care using your interventions
o Document Pt response to those interventions
- Evaluation:
o Compare results with planned outcomes and determine where you go from
there
-Admission - -Document advanced directive status: DNR or full code
o Collect vitals, height and weight, allergies
o Head to toe assessment, health history, spiritual/cultural considerations
o Assess for swallowing issues: do they have r/f aspiration
If yes: need evaluation from speech pathologist
o Safety assessment: r/f falls
o Inventory Pt belongings
o Put valuables in facility safe or have family take it home
o Medication reconciliation: compare home meds to providers prescriptions
o Discharge planning starts at admission****
-Transfer - -Use SBAR
-Discharge - -Pt receives pamphlet with instructions
Diet/activity restrictions
Instructions for home procedures: wound care
Instructions and supply
Meds: what to take, when to take, and precautions
s/s of complications and when to seek medical attention
ex. If they spike a fever or have increased erythema
follow up appointment
provide names and numbers of providers and community resources
-medical and surgical asepsis - -hand hygiene:
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